Making Sense of Glycemic Impact

Caution: Consult your diabetes care team before starting alower-carbohydrate meal plan. Diabetes medications such as insulin or oral drugsthat stimulate insulin production (sulfonylureas or meglitinides) will need adjustment to prevent hypoglycemia(low blood glucose) when carbohydrate intake is decreased. In addition, meds might need to be decreased, and bloodglucose levels need to be checkedmore often.

The Atkins Nutritional Approach is basedon eating foods with the lowest glycemicimpact. This can lead to improved bloodglucose control, minimizing or eliminatingthe need for diabetes drugs for type 2s andpossibly reducing the insulin dose for type1s.

All carbohydrate foods raise blood sugar. Theglycemic index (GI) represents how high andhow fast this occurs with an individual food.Pure sugar, or glucose, raises blood sugardramatically. So 50 grams of glucose (about 3tablespoons), which has a designated valueof 100, is the standard reference for the GI.

How Do You Ascertain the GI Rankingof a Food?

To ascertain the GI ranking of a food, healthyvolunteers consume a measured portion ofa carbohydrate food. Their blood glucoseis monitored, and the effect is compared tothat of sugar or white bread.

For example, a measured portion of potatoraises blood glucose 85 percent as much asthe standard does, so the potato’s GI rankingis 85.

Foods ranked from 0 to 55 on the glycemicindex are considered to have a low GI. Thoseat 56 to 69 are considered to have a mediumGI. Those at 70 and above have a highranking.

The glycemic index is based on portionscontaining 50 grams of availablecarbohydrates. (Remember that the fiber infood is not digestible.) That may be a normalportion in the case of pasta; however, whenit comes to high-fiber foods, it’s unrealistic.

For example, you have to eat six cupsof carrots to consume 50 grams ofcarbohydrates. A normal portion of halfa cup will actually provoke a much lowerglycemic response.

The Glycemic Load

To be more precise, researchers developedthe glycemic load (GL), a measure of the GIranking multiplied by the number of gramsof available carbohydrates per serving,which is then divided by 100. (The grams ofavailable carbohydrate generally representtotal carbs minus fiber.)

A GL of 10 or below is considered low; 11 to19, medium; and 20 or more, high.

It is important to understand both the GIand the GL numbers, because researchhas shown that a high-glycemic diet isassociated with higher blood glucose levelsand an increased risk for heart disease.

The late Robert Atkins, MD, developed aneasier-to-use tool that takes into accountboth the GI and GL, sorting foods into low,medium and high Atkins Glycemic Ranking(AGR). These three tiers make it easier tochoose more healthful carbohydrate foods(See below). In general, low AGR foodscontain the most fiber and can be eatenmore frequently. Portion size and thenumber of grams of carbs must still be takeninto consideration.

Not all low AGR foods are appropriate forthe weight-loss phases of the Atkins diet.In addition, the amount of fat, protein andfiber in the meal can moderate the glycemicresponse of a single food.

A comprehensive list of foods and their AGRscan be found in “Atkins Diabetes Revolution”(William Morrow, 2004).

Food With aLow Atkins Glycemic Ranking

Broccoli

Cucumbers

Mushrooms

Onions

Peppers

Spinach

Tomatoes

Zucchini

Cream

Cheese

Almonds

Sunflower seeds

Walnuts

Lentils

Soybeans

Tofu

Barley

Oatmeal (old fashioned)

Wheat germ

Apples

Blueberries

Grapefruit

Plums

Strawberries

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